Gender, stressful life events and interactions with sleep: a systematic review of determinants of adiposity in young people

Does COVID-19 Infection during Pregnancy Increase the Appearance of Congenital Gastrointestinal Malformations in Neonates?

BACKGROUND

COVID-19 was an infection that was capable of bringing the entire world to a standstill position within a period of days to months. Despite the advancements in the medical sector, the contagion was difficult to control and costed the lives of millions of people worldwide. Many short- and long-term effects are witnessed even to date in people that contracted the disease. Pregnant females had to suffer not only the devastating effects of the virus, but also the psycho-social impact of the lockdown. The impact of COVID-19 infection during pregnancy causing decreased antenatal care or hypoxemic episodes due to severe respiratory distress and whether it could lead to the appearance of congenital gastrointestinal malformation in neonates is still unclear. The aim of our study was to analyze if COVID-19 infection during pregnancy could increase the incidence of gastric malformations in neonates born from these women.

MATERIALS AND METHODS

We sifted the files of all neonates admitted into our hospital between January 2022 and December 2022, and based on inclusion and exclusion criteria, we included the cases having gastrointestinal congenital malformations during the COVID-19 pandemic. We performed a single-center, retrospective, observational descriptive study. We further divided the patients based on the anatomical location of the malformation. We also took down details of the evolution of pregnancy and whether the mother had contracted a SARS-CoV-2 infection during the pregnancy. Details regarding the Apgar score, days of intensive care admission, sex, and nutrition were the key findings studied.

RESULTS

A total of 47 neonates were found to have digestive anomalies, among which, based on the anatomical locations, the number of malformation cases found at the level of the esophagus were 15, while 16 occurred at the level of the pylorus; we found 12 cases of malformation of the duodenum, and four cases had malformation of the rectum. Out of these 47 neonates, 38.3% were females and 61.7% were males. A total of 58% were preemies, among which 9% had intra-uterine growth retardation (IUGR), and 42% were full-term newborns, among which 4% had intra-uterine growth retardation (IUGR). A total of 45% of the births were primiparous pregnancies and 55% were from multiparous females. A total of 14 mothers were found to have tested positive for COVID-19 during the course of pregnancy (p-value = 0.23); many had mild symptoms but were not tested.

CONCLUSIONS

COVID-19 can affect the wellbeing of the pregnant female and their fetus. Larger studies can help gain extensive knowledge as to whether COVID-19 also has the potential to result in congenital gastrointestinal anomalies in children born from COVID-19 positive mothers. In our study, only a few infants born with this pathology were found to be born from COVID-19 positive mothers. Hence, it is difficult to conclude or exclude a direct correlation between the infection and the congenital malformations.

Associations between Stressful Life Events and Increased Physical and Psychological Health Risks in Adolescents: A Longitudinal Study

Stressful life events (SLEs) are understood as risk factors for mental and physical health problems, particularly in the vulnerable period of adolescence. Using a longitudinal approach, this study investigated associations between SLE and several negative health outcomes in adolescents. Moderating effects of sociodemographic factors were considered. We analyzed the data of a healthy adolescent sample from the LIFE Child study in Leipzig, Germany (n = 2024, aged 10-18 years). SLEs were measured by a questionnaire, addressing SLEs in the family and the social environment domain. Health-related quality of life (HrQoL), behavioral difficulties and BMI were compared before and after an SLE had occurred. Moderator effects of socioeconomic status (SES), age, and sex were investigated using linear regression models. All considered health parameters had, on average, deteriorated after the occurrence of an SLE in the social environment. Differences in HrQoL before and after an SLE were significantly stronger in girls. Higher SES functioned as a slight protective factor against decreased well-being after an SLE. The findings suggest that SLEs function as risk factors for mental and physical health disadvantages in adolescents. Prevention programs should seek to support adolescents in all age and SES groups affected by SLEs, with a specific focus on girls.

Sleep Quality Before and After Bariatric Surgery

PURPOSE

Sleep deprivation is associated with growth hormone deficiency and an elevated cortisol level, both of which have been linked to obesity. However, assessing sleep quality is often not established in the multidisciplinary peribariatric evaluation program. This study aimed to determine sleep quality in patients who are seeking or underwent bariatric surgery by using Pittsburgh Sleep Quality Index (PSQI) measurements.

MATERIALS AND METHODS

In this observational study, patients who underwent or were seeking bariatric surgery between April and November 2021 were included. Self-reported patients' demographics, operative techniques, and sleep quality measured by PSQI were collected. Baseline characteristics were compared between the preoperative group (PRE), patients who underwent surgery < 1.5 years ago (EARLY), and > 1.5 years ago (LATE). A multivariate linear regression model was built.

RESULTS

In total, 270 patients filled out the questionnaire of which 100 (37.1%) were preoperative, 87 (32.2%) early, and 83 (30.7%) late postoperative. The PSQI significantly improved in the EARLY group compared to PRE (4.8 vs 6.1). This effect disappeared in the LATE group (6.1) even though their body mass index was less. Linear regression revealed that age (p = 0.004) and body mass index (p = 0.003) predicted worse sleep quality.

CONCLUSION

Sleep quality improves early after bariatric surgery; however, this benefit does not seem to last in the long term. Other factors than weight regain should be considered for this finding, future studies with longer follow-up periods are recommended, including other variables associated with sleep quality such as health conditions and socioeconomic status.

Mental health of Turkish medical students during the COVID-19 pandemic

BACKGROUND

The coronavirus disease emerged in 2019, spread in Turkey as all over the world rapidly. In this process, young people began to experience some mental problems due to the fear of contagion, as well as some changes in their lifestyles.

AIMS

In this study it is aimed to investigate anxiety and depression levels of medical school students and the factors associated with these mental problems.

METHOD

The forms were sent over the internet to the officials responsible for medical education at universities in various regions of Turkey. A total of 2,778 medical faculty students were included in the study. Students were asked to fill out the sociodemographic data form, the Patient Health Questionnaire - 9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) Test.

RESULTS

Students' 67.3% were female and 31.7% were male. About 90.2% of the students in the PHQ-9 scale had depressive symptoms in the major depressive disorder (MDD) dimension, and 44.5% in the GAD-7 scale had moderate/severe anxiety symptoms. Gender, being a preclinical student, history of psychiatric treatment in the past, currently receiving psychiatric treatment, death of someone due to pandemic, economic and health situation, perception of mental health were found associated with MDD and Moderate/Severe Anxiety symptoms. Students with Anxiety and MDD reported significantly more anxiety about contamination and negative beliefs about precautions' sufficiency.

CONCLUSIONS

It was determined that medical school students in our country showed anxiety and depression at a remarkable level during the pandemic. Examining the underlying causes of these high rates will be beneficial in terms of taking precautions during the long-term pandemic. In literature, there are a limited number of studies on this subject in our country, we believe that our study will be useful in future studies to determine the underlying causes of mental illnesses and what can be done to help students.

The psychological impact of COVID-19 on university students in China and Africa

The COVID-19 pandemic is alarmingly a global health catastrophe that has created an unprecedented mental health decline especially in young adults, who have been noted to be a vulnerable population. In this study, we investigated the prevalence of depression and anxiety in university students in China and Africa during the COVID-19 pandemic, the significant factors contributing to the prevalence of anxiety and depression, the differences in factors affecting the different groups being investigated and to emphasize that psychological intervention are as important as the physical interventions during and after the pandemic. The study was conducted through online surveys, with 684 participants using Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 standardized scales. Comparing all groups combined, of the 636 participants, 361 (56.8%) had depression and 227 (35.7%) had anxiety. Chi squared tests at significance level (P<0.05) showed that country of citizenship, religion, parents’ educational background, household monthly income and, having family members with COVID-19 variables were strongly associated with depression and anxiety. In contrast, age, gender, educational background, and major showed no significant association. Comparing the individual groups separately using chi square (P<0.05), the Chinese students in China group had 35.6% with depression and 13.1% with anxiety. The variable associated with both depression and anxiety was education major, with depression only was parent’s educational background and with anxiety only was gender. The African students in China group had 70.3% with depression and 45.0% with anxiety. Gender was strongly associated with both depression and anxiety, and religion and having family members with COVID-19 with anxiety only. Africans in Africa had 66.0% with depression and 50.5% with anxiety. Educational background was strongly associated with depression. There was no statistically significant variable for anxiety. Chi square test showed a statistically significant difference in depression and anxiety levels with the Chinese group compared to both African groups, and no significant difference between both African groups. Our findings demonstrated that COVID-19 had a negative psychological impact on university students. Therefore, more attention should be put on youth’s mental health during this pandemic.

Reflection of vaccine and COVID-19 fear in young groups in the COVID-19 pandemic

OBJECTIVE

This study aims to determine the fear of COVID-19 through the opinions of individuals under the age of 18 on the COVID-19 vaccine and vaccination.

METHODS

This cross-sectional study was conducted on 290 high school students studying in a central district between February 15, 2021, and March 1, 2021. The questionnaire consisted of questions about the sociodemographic characteristics of the students and COVID-19 infection and the Fear of COVID-19 Scale.

RESULTS

The age of the participants ranged from 14-18; 76.9% of the study group consisted of female students; and 76.9% of the participants declared that they live in middleincome households. Participants reported that they lived in the same house with at least 2 and a maximum of 12 people; 9.7% of the participants reported that they had a COVID-19 infection; 62.4% of the participants reported that they want to get the COVID-19 vaccine; and 55.2% of the participants reported that the COVID-19 vaccine will reduce the transmission. The mean obtained from the Fear of COVID-19 Scale is 3.38±4.75 in the whole group. It was determined that there was a significant difference between genders, the effect of the vaccine on the incidence, the status of having a COVID-19 infection, and the score of the Fear of COVID-19 Scale.

CONCLUSION

The attitudes of young individuals, who are one of the vulnerable groups during pandemic periods, toward vaccination are important in terms of infecting those they come into contact with and increasing the rate of infection.

Fear and depressive symptoms amid COVID-19: A cross-sectional pilot study among adult population in Bangladesh

BACKGROUND

Fear is a primary emotional reaction to the deadly coronavirus disease which might be an associated factor for developing depressive symptoms. This study aimed to assess the level and associated factors of fear and depression amid the COVID-19 pandemic among the adult population of Bangladesh.

METHODS

After providing informed consent, 1050 participants completed the cross-sectional online survey tool. Depressive symptoms and fear were assessed through the PHQ-9 and validated fear of COVID-19 scale (FCV-19S), respectively. Linear regression analysis was performed to predict potential factors of fear and depression.

RESULTS

The study finds that females had higher scores for fear of COVID-19 scale (β1' = 1.81; 95% CI: 1.15 to 2.47) and Patient Health Questionnaire (β2' = 1.92; 95% CI: 0.95 to 2.88) than their male counterpart. Respondents considering the virus to be extremely dangerous had higher scores for FCV-19S (β1' = 1.55; 95% CI: 0.66 to 2.44) and PHQ-9 (β2 = 1.59; 95% CI: 0.25 to 2.92). Similarly, respondents considering themselves unsafe and very worried about the virus had increased scores for both FCV-19S and PHQ-9. On other hand, people those were reluctant to use masks (β1' = -1.58; 95% CI: -3.12 to -0.04) or seek doctors' advice (β1' = -0.93; 95% CI: -1.83 to -0.02) if COVID-19 symptoms appear, had comparatively lower scores for FCV-19S.

CONCLUSIONS

Fear of COVID-19 and depression were found to be associated with some specific knowledge, attitude & preparedness towards COVID-19 which should be adequately addressed in public health strategies to prevent the virus.

The role of dietary diversity in preventing metabolic-related outcomes: Findings from a systematic review

Dietary diversity has been linked to insulin resistance; however, studies are inconsistent on whether dietary diversity protects against metabolic-related outcomes. We aimed to comprehensively assess metabolic-related outcomes of greater diversity across the diet and within major food groups. A systematic search of peer-reviewed literature was done in bibliographic databases (Medline, Scopus, and Web of Science) for longitudinal studies that reported on original research. Data extraction and quality appraisal used predefined criteria; reported findings were synthesized through a narrative approach. Fourteen studies were identified as eligible. Greater dietary diversity across major food groups, and diversity within fruits and/or vegetables, was associated with reduced risk of type 2 diabetes (T2D). Effects varied based on exposure definition and adjustment for known confounders. While diversity of less healthy foods was associated with greater adiposity, diversity of all foods and healthy foods was associated with reduced incidence of depression and cognitive decline. Evidence supports the protective effect of dietary diversity against cognitive decline and T2D. The association between dietary diversity and adiposity may be dependent on the healthiness of foods. Public health efforts to prevent metabolic-related diseases should include an emphasis on a varied diet as a healthy eating strategy.

Is eating a mixed diet better for health and survival?: A systematic review and meta-analysis of longitudinal observational studies

The role of dietary diversity in chronic disease or survival is controversial. This meta-analysis quantified the health impact of dietary diversity. Random-effects models pooled risk ratios (RRs) and 95% confidence intervals (CIs) of 20 longitudinal studies. Total dietary diversity was associated with a 22% lower risk of all-cause mortality (RR 0.78 [95%CI: 0.64, 0.96]), and was inversely associated with incident cancer- or CVD-specific mortality only in subgroup analyses (RR range: 0.53 to 0.90, p < 0.05). Similarly, diversity across healthy foods was inversely associated with all-cause mortality (RR 0.84 [95%CI: 0.73, 0.96]). An inverse association between total diet diversity and incident CVD was significant in non-European populations consuming diets with diverse food groups (RR: 0.93 [95% CI: 0.86-0.99]). Effects on cancer risk are unstudied. Diversity within fruits and/or vegetables showed null associations for all outcomes, except potentially for squamous cell-type carcinomas. More robust research is warranted. Findings indicated greater dietary diversity may benefit overall survival.

Fear of COVID-19 Scale-Associations of Its Scores with Health Literacy and Health-Related Behaviors among Medical Students

The coronavirus disease 2019 (COVID-19) pandemic causes fear, as its immediate consequences for the public have produced unprecedented challenges for the education and healthcare systems. We aimed to validate the fear of COVID-19 scale (FCoV-19S) and examine the association of its scores with health literacy and health-related behaviors among medical students. A cross-sectional study was conducted from 7 to 29 April 2020 on 5423 students at eight universities across Vietnam, including five universities in the North, one university in the Center, two universities in the South. An online survey questionnaire was used to collect data on participants' characteristics, health literacy, fear of COVID-19 using the FCoV-19S, and health-related behaviors. The results showed that seven items of the FCoV-19S strongly loaded on one component, explained 62.15% of the variance, with good item-scale convergent validity and high internal consistency (Cronbach's alpha = 0.90). Higher health literacy was associated with lower FCoV-19S scores (coefficient, B, -0.06; 95% confidence interval, 95%CI, -0.08, -0.04; p < 0.001). Older age or last academic years, being men, and being able to pay for medication were associated with lower FCoV-19S scores. Students with higher FCoV-19S scores more likely kept smoking (odds ratio, OR, 1.11; 95% CI, 1.08, 1.14; p < 0.001) or drinking alcohol (OR, 1.04; 95% CI, 1.02, 1.06; p < 0.001) at an unchanged or higher level during the pandemic, as compared to students with lower FCoV-19S scores. In conclusion, the FCoV-19S is valid and reliable in screening for fear of COVID-19. Health literacy was found to protect medical students from fear. Smoking and drinking appeared to have a negative impact on fear of COVID-19. Strategic public health approaches are required to reduce fear and promote healthy lifestyles during the pandemic.

Stressful life events, gender and obesity: A prospective, population-based study of adolescents in British Columbia

Objective

To determine whether stressful life events are related to levels of obesity in a group of ethnically diverse Canadian youth and the extent to which the relationship differs by gender.

Methods

This study of 905 adolescents (age 13–17 years) from a BC population-based cohort (BASUS) used self-reported data from Wave 5 (2011 fall) on stressful life events and socio-demographic factors and from Wave 6 (2012 spring) on weight and height. Multivariable logistic regression models conditioned on known confounders and used a cross-product term for effect modification by gender. Post-estimation analysis calculated gender-specific predicted mean probabilities of having obesity associated with greater frequency of stressful life events.

Results

Compared to young men reporting no stressful life events in the previous year, young men reporting one event were nearly 50% more likely to have obesity at 6-month follow-up (OR 1.47 [95% CI: 0.63, 3.41]) and those reporting multiple stressful life events were twice as likely to have obesity at 6-month follow-up (OR 2.07 [95% CI: 0.79–5.43]). Only young women reporting multiple events showed a higher likelihood of having obesity at the end of the study (OR 1.32 [95% CI: 0.41–4.18]) than their counterparts reporting no life events.

Conclusions

Results suggest that the frequency of major life events may be an important social stressor associated with obesity in adolescents, particularly for young men. However, findings should be replicated in larger samples using measured anthropometry to inform future obesity prevention strategies.

Association between Cluster of Lifestyle Behaviors and HOMA-IR among Adolescents: ABCD Growth Study

Objective: To analyze the association of potential risk factors to health with body fatness and insulin resistance. Baseline measures of the ongoing longitudinal Analysis of Behaviors of Children During (ABCD) Growth Study. Materials and Methods: The sample was composed of 280 adolescents of both sexes (198 boys and 82 girls) aged from 10 to 18 years. Four risk factors were considered, as follows: no sports practice, skipping breakfast, poor sleep quality, and TV viewing. The outcomes considered were insulin resistance (HOMA-IR) and body fatness (densitometer scanner). Age, sex, maturity offset, and ethnicity were treated as covariates. Results: No sports practice and skipping breakfast were associated with higher body fatness (Sports practice: Wald: 8.786; p = 0.003. Breakfast: Wald: 9.364; p = 0.002). Poor sleep quality was related to a greater HOMA-IR index (Wald: 6.013; p = 0.014). Adolescents with ≥3 risk factors presented a higher risk of high HOMA-IR (OR = 4.89 (95%CI: 1.61 to 14.84)) than their counterparts with no risk factors. Conclusion: Lifestyle risk factors seem relevant to affect obesity and insulin resistance, while the aggregation of these risk factors affects insulin resistance, independent of adiposity.

Association between Cluster of Lifestyle Behaviors and HOMA-IR among Adolescents: ABCD Growth Study

Objective: To analyze the association of potential risk factors to health with body fatness and insulin resistance. Baseline measures of the ongoing longitudinal Analysis of Behaviors of Children During (ABCD) Growth Study. Materials and Methods: The sample was composed of 280 adolescents of both sexes (198 boys and 82 girls) aged from 10 to 18 years. Four risk factors were considered, as follows: no sports practice, skipping breakfast, poor sleep quality, and TV viewing. The outcomes considered were insulin resistance (HOMA-IR) and body fatness (densitometer scanner). Age, sex, maturity offset, and ethnicity were treated as covariates. Results: No sports practice and skipping breakfast were associated with higher body fatness (Sports practice: Wald: 8.786; p = 0.003. Breakfast: Wald: 9.364; p = 0.002). Poor sleep quality was related to a greater HOMA-IR index (Wald: 6.013; p = 0.014). Adolescents with ≥3 risk factors presented a higher risk of high HOMA-IR (OR = 4.89 (95%CI: 1.61 to 14.84)) than their counterparts with no risk factors. Conclusion: Lifestyle risk factors seem relevant to affect obesity and insulin resistance, while the aggregation of these risk factors affects insulin resistance, independent of adiposity.

Association between Cluster of Lifestyle Behaviors and HOMA-IR among Adolescents: ABCD Growth Study

Objective: To analyze the association of potential risk factors to health with body fatness and insulin resistance. Baseline measures of the ongoing longitudinal Analysis of Behaviors of Children During (ABCD) Growth Study. Materials and Methods: The sample was composed of 280 adolescents of both sexes (198 boys and 82 girls) aged from 10 to 18 years. Four risk factors were considered, as follows: no sports practice, skipping breakfast, poor sleep quality, and TV viewing. The outcomes considered were insulin resistance (HOMA-IR) and body fatness (densitometer scanner). Age, sex, maturity offset, and ethnicity were treated as covariates. Results: No sports practice and skipping breakfast were associated with higher body fatness (Sports practice: Wald: 8.786; p = 0.003. Breakfast: Wald: 9.364; p = 0.002). Poor sleep quality was related to a greater HOMA-IR index (Wald: 6.013; p = 0.014). Adolescents with ≥3 risk factors presented a higher risk of high HOMA-IR (OR = 4.89 (95%CI: 1.61 to 14.84)) than their counterparts with no risk factors. Conclusion: Lifestyle risk factors seem relevant to affect obesity and insulin resistance, while the aggregation of these risk factors affects insulin resistance, independent of adiposity.